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Updated: Jun 5, 2026

Subcutaneous Trigeminal Nerve Field Stimulation for Refractory Facial Pain
Published on: May 10, 2017
Immune trigeminal sensory neuropathy with esophageal achalasia: improvement with long-term immunotherapy
Juan J Figueroa1, Janean K Engelstad, Robert J Spinner
1Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA.
Abstract:
We report a patient who developed subacute facial-predominant numbness and anhidrosis, oral incoordination, and esophageal achalasia with resultant cachexia. Great auricular nerve biopsy showed extensive epineurial perivascular inflammatory infiltrates. Sensation, sweating, and swallowing improved with pulse intravenous methylprednisolone given over 5 years. We suggest that the patient's deficits, including achalasia, were due to an immune-mediated sensory and autonomic neuropathy and that, in such cases, pathologic studies of the great auricular nerve may be diagnostically informative.
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